Smoking cessation and relapse prevention system

ABSTRACT

A computer-based system for monitoring and improving a user&#39;s compliance with a smoking cessation and relapse prevention program by providing the user with multiple forms of feedback designed to encourage adherence to the program. The system “calls” the user on the telephone at the end of each day and prompts the user to input the number of cigarettes smoked that day. The system accepts and stores the input and calculates whether the user is achieving their program goal (either a zero-cigarette goal, or a reduced-smoking goal under a step-down program), and gives positive or negative feedback based on whether the user is meeting their program goals.

BACKGROUND

1 . Field of the Invention

This patent relates to the field of smoking cessation and relapse prevention systems. More particularly, this patent relates to a system and apparatus for monitoring and improving a user's compliance with a smoking cessation program by providing the user with multiple forms of feedback designed to encourage adherence to a smoking cessation program and avoidance of a smoking relapse.

2. Description of the Related Art

People find it difficult to quit smoking and avoid relapses after quitting. This is true even though most smokers understand the very serious health risks of continued smoking. Many smokers relapse even after they have overcome their physical addiction to nicotine. There are several reasons why quitting and avoiding relapse is difficult.

First, the feedback loop from quitting smoking to reduced risk of health problems is not effective as behavioral reinforcement. The smoker can continue to smoke with no symptomatic feedback for decades. By the time the feedback (symptoms of a smoking-related disease) arrives, serious damage has already been done. Creating an effective behavioral feedback loop requires additional, faster feedback to the user.

Second, people find it difficult to hold themselves accountable without outside assistance. Ex-smokers are often pressured to smoke by peers, and are often tempted to smoke during times of stress. However, the ex-smoker who knows he will be held accountable in some way by an outside party has an incentive to resist temptation.

Third, smokers who quit but relapse need an immediate intervention that gives them an incentive to get back on their quitting program. One solution to this problem involves taking a smoker who has relapsed for one day and holding themto a higher level of accountability for the next day, rather than declaring the quit attempt a failure and having no accountability for the next day.

Finally, the physical addiction to nicotine causes smokers to suffer withdrawal symptoms when quitting. A program of gradually reducing nicotine intake reduces withdrawal symptoms. One way to accomplish this is by stepping down cigarette consumption over time, until the smoker is ready to quit completely.

Thus it is an object of the present invention to remedy these four problems. The present invention shortens the feedback loop by interacting with the user on a daily basis. It serves as an outside source of accountability for the user by questioning him about his smoking behavior. If the user's answers reveal that he has relapsed, the system performs an intervention by holding the user to a higher level of accountability for future behavior. Finally, the system provides a means to implement a step-down program, if desired by the user, to reduce withdrawal symptoms.

Further and additional objects will appear from the description, accompanying drawings, and appended claims.

Various systems that monitor a user's smoking behavior and provide feedback are known in the art, although none approach the problem in the same way as the present system. Some of them are described below.

Behar U.S. Pat. No. 4,853,854 discloses a human behavior modification system that can be used to assist a user to stop smoking. The system involves the use of a pocket-sized device for receiving and transmitting information from and to the user. The system works by generating a smoking withdrawal schedule and calculating time intervals between permitted smoking events. The system can provide the user with audible or visual stimuli, for example, when it is appropriate to smoke the next cigarette and the time remaining until the end of the withdrawal phase. Unlike the present invention, the Behar system requires a baseline phase for data collection prior to operating in a withdrawal phase. Also unlike the present invention, the Behar device requires the user to inform the system each time he or she smokes a cigarette.

Segel et al. U.S. Pat. No. 5,967,789 discloses a method and system for modifying smoking behavior. The system collects data from a user regarding the user's smoking habit, uses the data to generate personalized behavioral change messages, and transmits those messages to the user in a visually perceptible form on a daily basis. Like the present invention, the Segel system can receive data from a user telephonically, although unlike the present invention Segel teaches that feedback is provided “preferably in hard copy form”. Also unlike the present invention, the Segel system does not automatically prompt the user to input the number of cigarettes smoked each day.

Brue U.S. Pat. No. 6,606,997 discloses a passive smoking cessation device consisting of a cigarette case that automatically provides a signal that a cigarette has been smoked each time the lid is raised. The device's LCD display can provide feedback to the user such as a blinking light when cigarette smoking is permitted, the number of cigarettes smoked, or the time until the next allowed cigarette. Unlike the present invention, the Brue device does not automatically contact the user each day or require that the user actively input a number of cigarettes smoked each day.

Perlman et al. U.S. Pat. No. 6,839,305 discloses a wristwatch type device having a button that the user taps each time a cigarette is smoked, a timer that calculates the time between each cigarette smoked, and auditory or visual means of providing feedback to the wearer. Like the present invention the Perlman device can provide positive feedback to a compliant user. Unlike the present invention, the Perlman device does not work telephonically, does not automatically contact the user once each day, and does not require that the user to input a number of cigarettes smoked each day.

Brue U.S. Pat. No. 7,028,693 discloses a smoking reduction method that collects data regarding a user's daily cigarette consumption and generates a reduced smoking regimen that equally distributes the reduced number of cigarettes consumed during the day. The data may be inputted passively (preferred) or actively. In the passive, preferred, mode each day's cigarette consumption is automatically inputted to an electronic device by a cigarette case having a built-in device for sensing when the case lid is opened. In the active mode the user can input the data remotely by using, for example, a mobile phone. The system is also capable of providing positive feedback. Unlike the present system, the Brue system does not have an alert subroutine or a subroutine for informing the user that they need additional assistance.

Cobb et al. U.S. Patent Publication No. 2004/0016437 discloses a behavioral modification method and system that can be used to help a user stop smoking. Like the present invention the system accepts user supplied data regarding the user's smoking habit and can operate telephonically. Unlike the present invention the Cobb system does not automatically contact the user each day, nor is it designed to continue to help the user after they have stopped smoking.

SUMMARY OF THE INVENTION

The present invention is a computer-based system for monitoring and improving a user's compliance with a smoking cessation program by providing the user with multiple forms of feedback designed to encourage adherence to the program. The system “calls” the user on the telephone at the end of each day and prompts the user to input the number of cigarettes they smoked that day. The system accepts and stores the input and calculates whether the user is achieving their program goal (either a zero-cigarette goal or a reduced-smoking goal under a step-down program), and gives positive or negative feedback based on whether the user is meeting their program goals.

The system hardware requirements include a data processing device such as a personal computer, a video display monitor, and means for inputting data (such as a keyboard.) The computer should have an internal telephony card for two-way remote communications, and the user should be equipped with a telephone communication device such as a cell phone for receiving messages from the system and for inputting data (such as the number of cigarettes smoked) into the data processing device. Software requirements include a database management system (such as Microsoft Access), and computer telephony application software.

The system works in the following manner. First, the user inputs into the computer his or her identification data. The user also inputs data to create either a stepdown program (reducing smoking gradually before quitting) or a program for immediate smoking cessation.

At a specified time at the end of each day the system calls the user on the telephone and queries the user, asking how many cigarettes he or she smoked that day. The user inputs the number (including zero, if appropriate) into the system using the telephone. The system compares the input to the user's target for that day. If the user met the target, the system provides positive feedback (including, if appropriate, the number of days the user has been smoke-free). If the user exceeded the target, the user is placed ‘on alert’, indicating a higher level of accountability for the next three days.

If a user who is placed ‘on alert’ meets his or her targets for three days, he or she is changed back to ‘in good standing’ status and given positive feedback. However, if the user exceeds his or her target (smokes too much) while on alert, the system connects the call through to a pre-specified phone number, such as a state or local smoking cessation helpline, where the user can obtain counseling and help in quitting.

THE DRAWINGS

FIG. 1 is a schematic diagram of a smoking cessation and relapse prevention system according to the present invention.

FIG. 2 is a schematic representation of the software requirements of the smoking cessation and relapse prevention system of FIG. 1.

FIG. 3 is a sample screen view of a User Interface used in the smoking cessation and relapse prevention system of FIG. 1.

FIG. 4 is a flowchart for the routine used to establish the phone callwith the user each day.

FIG. 5 is a flowchart for the routine used to interact with a user whose user state is “In Good Standing”

FIG. 6 is a flowchart for the routine used to interact with a user whose user state is “On Alert.”

DETAILED DESCRIPTION OF THE INVENTION

The present invention is a computer-based system for monitoring and improving a user's compliance with a smoking cessation and/or relapse prevention program by providing the user with multiple forms of feedback designed to encourage adherence to their specialized program. The system “calls” the user on the telephoneat the end of each day and prompts the user to input the number of cigarettes they smoked that day. The system accepts and stores the input and calculates whether the user is achieving their program goal (either a zero-cigarette goal, or a reduced-smoking goal under a step-down program), and gives positive or negative feedback based on whether the user is meeting their program goals.

Hardware Requirements

One embodiment of the present invention is shown schematically in FIG. 1. The system 10 hardware requirements include a data processing device 12 such as a personal computer having means for receiving and storing personal information and smoking cessation program compliance information about a user, a video display monitor 14 and means for inputting data 16 (such as a keyboard). The computer 12 should have means for remotely contacting the user at the end of each day, such as an internal telephony card 18 wired to an analog phone port 19 for two-way remote communication, and processing means for calculating whether the user is in compliance by comparing the user's input to the targets specified in the user's smoking cessation program, and means for generating an appropriate feedback message and transmitting that message to the user.

In one embodiment, the computer 12 is a commercially available Hewlett-Packard Pavilion a630n desktop PC running the Windows XP operating system with an Intel Runtime License serial port plug. The computer 12 must include means for remote communication with the user, such as Intel's D41-JCTLS 4-port telephony card, if the means of communication is by telephone, or an Ethernet card, if the means of communication is Voice Over Internet Protocol (VOIP) telephone communication. If a telephony card is used, multiple phones lines per card and multiple cards per computer are possible.

The user should be equipped with a remote communication device 20 such as a telephone or cell phone for receiving messages from the computer 12 and for inputting data (such as the number of cigarettes smoked that day) into the data processing device 12.

The computer 12 may be any suitable data processing device, such as a commercially available Hewlett-Packard Pavilion a630n desktop PC running the Windows XP operating system with an Intel Runtime License serial port plug and an Intel D41-JCTLS 4-port telephony card installed. Multiple phone lines per card and multiple cards per computer are possible where the system involves multiple users (smokers). Alternatively, and for illustration purposes only, the computer 12 can be equipped with Voice Over Internet Protocol.

Software Requirements

As shown in FIG. 2, software requirements include, for example, a database management program 22 (such as Microsoft Access 2003), forms software 24 (such as Microsoft Access Forms 2003 with VBA Macros), and executable computer telephony application software (CTAS) 26. The application software 26 controls the telephony card 18, makes calls to the user, and takes the user's telephone input. The application software can accept telephone keypad input or, alternatively, use voice-recognition technology to accept spoken user input.

The application software was written in the Intel Computer Telephony Application Development Environment (CTADE) using Intel's proprietary programming language and flowcharting tools. The CTADE includes a compiler which was used to compile the application and make it executable on a PC.

The User Interface Page (FIG. 3) shows each user's contact information and allows input of a baseline number of cigarettes per day for that user. The “Number of Cigarettes per Day” is an input field; it refers to the number the user smokes as of the beginning of the quitting plan. The “SmokeFreeDate” is an output field; it is based on the number of cigarettes inputted by the user and is calculated by the system based on a gradual reduction in smoking each day. The “Phone 1” and “Phone 2” fields are the designated telephone numbers at which to call the user.

Manner of Operation

User Information Input (Initialization Step)

The system works in the following manner. First, using the user interface screen (FIG. 3), the user inputs into the computer 12 his or her identification and contact data (e.g. name and telephone number(s)), and a daily prompt time (“Time To Call”). The user also inputs data into the ‘Number of Cigarettes Per Day’ field to generate an appropriate smoking cessation program. Inputting zero into the ‘number of cigarettes’ field produces a smoking cessation program that calls for the user to quit smoking immediately—the user's target is always zero cigarettes per day. Inputting a positive number of cigarettes into the field causes the software to generate a step-down program, in which the target number of cigarettes is reduced each day until the target reaches (and remains at) zero. The user's prospective quit date, which is calculated by the system and is a function of the “Number of Cigarettes per Day”, is shown in the ‘SmokeFreeDate’ field on the screen.

Smoking Inquiry and Response

The system 10 can be used by multiple users at the same time. To accommodate multiple users, the database management program 22 runs in a continuous loop. At the beginning of the loop, the program 22 determines what call to make next. First, the program 22 looks in the database and finds the set of all calls that are due at that time. Then it sorts the calls in the order it will make them according to any suitable criteria, such as alphabetically by last name. The computer stores the ID of the user who is to be called first, then dials the user.

At the appropriate designated day and time, but typically each evening, the computer 12 queries the user (typically via telephonic communication) how many cigarettes the user has smoked that day. The user inputs the appropriate number, including the number zero if appropriate, into the computer using a telephone or cell phone 20.

If at any time when the user is being prompted for input the system does not ‘hear’ the user input (caused, for example, by a bad telephone connection), the system gives the user three tries and can then move the prompt (inquiry) one hour ahead of the current time and call back at that time.

If the user does not answer the telephone, the system can move the prompt time one hour ahead of the current time and call back at that time.

Calculation of User Status

After receiving a response from the user, the computer 12 compares the user's input with that day's target determined by the user's smoking cessation program and calculates the user's status. A user can have one of two status states: “In Good Standing” and “On Alert.” Based on the user's response to the telephone inquiry the system calculates the user's status by applying the following rules:

1) By default, the user starts out “In Good Standing.”

2) A user In Good Standing remains In Good Standing if his cigarette consumption was equal to or less than his target for that day.

3) A user In Good Standing is placed “On Alert” if his cigarette consumption was greater than his target number for that day.

4) A user On Alert remains On Alert until he has completed a given number of consecutive days—preferably three—of smoking a number of cigarettes equal to or less than his target number for that day. Then he is placed back In Good Standing.

5) If a user who is On Alert smokes more than his target number of cigarettes, the “Intervention” feature is triggered and the system transfers the call to a help line.

If a user enters a number equal to or lower than the target, the user is considered compliant that day. If the user enters a number higher than the target (for example, inputting five when the target is zero), then the user was noncompliant that day.

If a user in the ‘In Good Standing’ state remains compliant for that day, he or she will retain their “In Good Standing” status. The system will deliver positive feedback, with the feedback message depending on whether the user has already quit (target of zero) or is in a step-down phase (nonzero target). If the user has already quit, the feedback message will emphasize the number of days the user has been smoke-free, and encourage the user to continue that progress by remaining compliant tomorrow. If the user is in a step-down phase, the feedback message will emphasize the planned date on which the user will quit smoking completely if he continues to comply.

However, if a user ‘In Good Standing’ is noncompliant, the system places the user ‘On Alert’ and gives the user feedback encouraging future compliance. If the user ‘On Alert’ is compliant for three days in a row, the system congratulates the user and places him or her back into ‘In Good Standing’ status.

If the user is noncompliant while ‘On Alert’, the system delivers a feedback message and then connects the call through to a designated phone number where the user can obtain in-person help with smoking cessation. For example, the State of Mississippi operates a toll free “Tobacco Quitline” for Mississippi residents. As another example, a company that markets the present invention could create a call center to handle such calls. As another example, the user could designate the phone number of a friend who had quit smoking successfully or a friend who is trying to quit smoking at the same time. The user's status remains ‘on alert’ until the user completes three consecutive days of compliance.

Escalating Accountability Features

An important feature of the system is to structure the user's incentives at each stage of noncompliance by an escalating accountability system.

When the user is consistently compliant (“In Good Standing”), the danger is that the user will lose focus on the objective of continuing compliance. The system continues to call the user every single day as long as the user subscribes—perhaps for a year or more—and provides accountability by continuing to ask about smoking behavior. The system also gives the user a forward-looking incentive for continuing compliance. For example, if a user has been compliant for 36 days, the system encourages the user to make tomorrow “day 37” of the “smoke-free rest of your life.” This defines a specific, immediate, and realistic goal which should be motivating to the user. It also gives the user something specific to lose—a 36 day record of compliance—since the ‘counter’ will be reset on any instance of noncompliance.

On the first instance of noncompliance (for a user In Good Standing), the danger is that the user will immediately consider the quit attempt a failure—meaning that the user has no further accountability—and return to regular smoking. So the system escalates the user's accountability by putting the user ‘On Alert’ to indicate that the user's attempt to quit has not yet failed and to indicate a higher level of accountability for the next day. The system gives the user a specific, immediate, and realistic goal: if the user is compliant for the next three days, the user will no longer be ‘On Alert’ and instead will be an ex-smoker ‘In Good Standing’ again.

On the second instance of noncompliance (ie, noncompliance while ‘On Alert’), the system again escalates the user's accountability by initiating an intervention subroutine. The intervention subroutine comprises telling the user that because they weren't compliant while ‘On Alert’, it's time for them to ask for help. The system connects the user with a designated phone number (such as a call center established for this purpose) where live assistance with smoking cessation will be available. (This feature can be implemented either bytransferring the call, or by having the system add the designated number as the third party in a three-way call.)

This second escalation serves several purposes. It provides ‘On Alert’ users with an additional incentive to comply and avoid the escalation—since it's stressful to admit one's failures and ask for help from another human being. Also, it connects users with a much richer type of help than an automated system can provide. Finally, it changes the default from “not asking for help” to “asking for help”—since if the user simply does nothing then a smoking-cessation counselor will be on the line momentarily. The user would have to rudely hang up on another human being in order to avoid talking about their smoking problem with someone who can help.

Relapse Prevention Feature

Another important feature of the invention is its emphasis on relapse prevention during the user's zero-target phase. The system continues to call the user automatically each day for 365 days, or until the user instructs the system to stop calling (FIG. 3). The system (after the short, optional step-down phase) will use a target of zero cigarettes—in effect asking the user if he or she has relapsed after quitting. The purpose of these calls is not smoking cessation (since the user has already quit), but prevention of relapse after cessation.

The process of contacting the user telephonically and querying a userabout how many cigarettes they smoked that day is depicted diagrammatically in FIGS. 4-6 and described in detail in the examples below.

EXAMPLES

In the examples that follow, all text is spoken by a computer-generated voice. Plain text is spoken as shown, but where Boldface text is shown the information is based on data in the database specific to that user. For example, the user's name is in bold. The first three calls (Examples 1-3) are in sequence while the user is on a step-down program—on three successive days. The second three calls (Examples 4-6) happen later, after the user has successfully quit and remained smoke-free. Bracketed comments provide context for the dialog that follows each bracketed comment.

Example 1 User on Step Down Program; User in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user. (FIG. 4)]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

User Presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call, first informing the user of that day's target number of cigarettes, then inquiring about the user's cigarette use for that day. The user is currently “In Good Standing.” (FIG. 5).]

System: Your target for today was 11 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters the number 11, which is less than or equal to goal).

System: You entered the number 11. If that is incorrect, press one.

System: Congratulations! Take a moment to enjoy the feeling of achieving your goals. Your target for tomorrow is 9 cigarettes. If you stay on track, you will be smoke-free forever by Sep. 10, 2004.

Example 2 User on Step Down Program; User Not in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user. (FIG. 4).]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

Call recipient presses 2.

System: Please tell Jesse Hercules to press one when they answer the phone.

User comes to the phone and presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call, first informing the user of that day's target number of cigarettes, then inquiring about the user's cigarette use for that day. The user is “In Good Standing” at the start of the call. (FIG. 5).]

System: Your target for today was 9 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters the number 10, greater than goal).

System: You entered the number 10. If that is incorrect, press one.

System: You did not meet your target for today. For the next three days, consider yourself on alert, and either avoid the situations that cause you to smoke, or make sure you don't have cigarettes within reach at those times. If you meet your targets for the next three days, you will be off alert. If you do not meet your targets while on alert, you will need to speak with a counselor and ask for help. Your target for tomorrow is 8 cigarettes. If you stay on track, you will be smoke-free forever by Sep. 10, 2004.

Example 3 User on Step Down Program; User on Alert; User Not in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user (FIG. 4).]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

User Presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call, first informing the user of that day's target number of cigarettes, then inquiring about the user's cigarette use for that day. The user is “On Alert” at the start of the call (FIG. 6).]

System: Your target for today was 8 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters the number 10, greater than goal).

System: You entered the number 10. If that is incorrect, press one.

System: Even though you were on alert, you did not meet your target for today. That probably means you need to ask for help. Your target for tomorrow is 7 cigarettes. You will now be connected with a smoking cessation counselor. (System connects caller to designated phone number).

Example 4 User on Relapse Prevention Program; User in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user (FIG. 4).]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

User Presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call. Since the user has already quit (i.e. has a zero-cigarette target, the system informs the user that the day's target number of cigarettes was zero, and then inquires about the user's cigarette use for that day. The user is “In Good Standing” at the start of the call. (FIG. 5).]

System: Your target for today was 0 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters a zero).

System: You entered the number 0. If that is incorrect, press one.

System: Congratulations. You have been smoke-free for 20 days. Take a moment to enjoy the feeling of achieving your goals, and recommit to a smoke-free life. Make tomorrow day 21 of the smoke-free rest of your life. Good luck!

Example 5 User on Relapse Prevention Program; User Not in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user (FIG. 4).]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

User Presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call. Since the user has already quit (i.e. has a zero-cigarette target, the system informs the user that the day's target number of cigarettes was zero, and then inquires about the user's cigarette use for that day. The user is “In Good Standing” at the start of the call. (FIG. 5).]

System: Your target for today was 0 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters the number 1, which is greater than zero).

System: You entered the number 1. If that is incorrect, press one.

System: You did smoke today, but that doesn't mean you can't quit successfully. Quitting takes practice, like anything else. For the next three days, consider yourself on alert, and either avoid the situations that cause you to smoke, or make sure you don't have cigarettes within reach at those times. If you stay smoke-free for the next three days, you will be off alert. If you smoke again while on alert, you will need to speak with a counselor and ask for help.

Example 6 User on Relapse Prevention Program; User On Alert; User Not in Compliance That Day

[At the time specified by the user on the user interface screen (FIG. 3), the system calls the specified user telephone number (“Phone1”) and establishes the phone call with the user (FIG. 4).]

System: Hello, this is the BE Smokefree system calling. Press one if you are Jesse Hercules. Press two if you want to wait for that person to come to the phone. Press three if that person is unavailable.

User Presses 1.

[Having established the phone call with the user, the system proceeds with the substantive portion of the call. Since the user has already quit (i.e. has a zero-cigarette target, the system informs the user that the day's target number of cigarettes was zero, and then inquires about the user's cigarette use for that day. The user is “On Alert” at the start of the call. (FIG. 6).]

System: Your target for today was 0 cigarettes. Using the keypad, enter the number of cigarettes you smoked today.

(User enters the number 11, which is greater than zero)

System: You entered the number 11. If that is incorrect, press one.

System: Even though you were on alert, you smoked again today. That probably means you need to ask for help. You will now be connected with a smoking cessation counselor. (System connects caller to designated phone number).

It is understood that the embodiments of the invention described above are only particular examples which serve to illustrate the principles of the invention. Modifications and alternative embodiments of the invention are contemplated which do not depart from the scope of the invention as defined by the foregoing teachings and appended claims. For example, the system can be set up to inquire about smoking cessation program compliance more or less than once per day. The system can also inquire about cessation program compliance for other types of tobacco use or use of other substances. It is intended that the claims cover all such modifications and alternative embodiments that fall within their scope. 

1. A method for monitoring and improving a user's compliance with a smoking cessation and relapse prevention program, the method comprising the steps of: a computer automatically contacting the user telephonicallyat a pre set time of day and requesting the user to input into the computer a number of cigarettes smoked by the user that day; the user inputting into the computer system a numerical response representing the number of cigarettes smoked by the user that day; the computer comparing the numerical response to a user's target maximum number of cigarettes allowed that day and calculating whether or not the user is in compliance for that day; and the computer determining a compliance status level for the user and providing the user with feedback based on the compliance status level.
 2. The method of claim 1 wherein the compliance status level is either ‘In Good Standing’ or ‘On Alert’.
 3. The method of claim 2 wherein an initial compliance status level for a user is “In 2 0 Good Standing”.
 4. The method of claim 3 wherein a user having an “In Good Standing” compliance status level will continue to have that status level as long as the user is in compliance.
 5. The method of claim 4 wherein a user having an “In Good Standing” compliance status level will have their compliance status level changed to “On Alert” if the user is not in compliance on a particular day.
 6. The method of claim 5 wherein the user having a compliance status level of “On Alert” will continue to have that status level until the computer determines that the user has been in compliance for a predetermined number of consecutive days.
 7. The method of claim 6 wherein the predetermined number of consecutive days is three.
 8. The method of claim 6 comprising the further step of: the computer initiating an intervention subroutine when a user has a compliance status level of “On Alert” and the computer has calculated that the user is not in compliance.
 9. The method of claim 8 wherein the intervention subroutine comprises transferring the user to a help line.
 10. The method of claim 9 wherein the help line provides the user with access to a smoking-cessation counselor.
 11. The method of claim 1 further comprising, prior to the contacting step, a one-time user initialization step of: inputting into the computer identification data, a number of cigarettes currently smoked per day, and a time to be contacted each day.
 12. The method of claim 11 wherein the identification data includes the user's name and telephone number.
 13. The method of claim 11 wherein inputting “zero” as the number of cigarettes currently smoked per day causes the computer to assign a value of zero to the user's target maximum number of cigarettes allowed each day for the duration of the smoking cessation program.
 14. The method of claim 11 wherein inputting a positive number as the number of cigarettes currently smoked per day causes the computer to generate a smoking step down program in which the target maximum number of cigarettes allowed each day is reduced each day until it reaches zero.
 15. A computer-based system for monitoring and improving a user's compliance with a smoking cessation and relapse prevention program, the system comprising: a computer having means for receiving and storing personal information about the user, including the user's name, telephone number, daily contact time and current number of cigarettes smoked per day; means for calculating a user's smoking reduction schedule and smoke free date; means for automatically and remotely contacting the user at the daily contact time and making a smoking behavior inquiry including asking the user the number of cigarettes smoked that day; means for receiving and storing a user's responses; processing means for assigning the user a compliance status level based on the user's responses; and means for generating and delivering feedback to the user based on the user's compliance status and responses; and remote means by which the user can receive from the computer the smoking behavior inquiry, input to the computer a number of cigarettes smoked since the previous daily contact time, and receive from the computer a feedback message.
 16. A method for monitoring and improving a user's compliance with a substance use cessation and relapse prevention program, the method comprising the steps of: a computer automatically contacting the user telephonicallyat a preset time and requesting the user to input into the computer a number of times the user used the substance that day; the user inputting into the computer system a numerical response representing the number of times the user used the substance that day; the computer comparing the numerical response to a user's target maximum number of times the substance may be used that day and calculating whether or not the user is in compliance for that day; and the computer determining a compliance status level for the user and providing the user with feedback based on the compliance status level. 